Posts Tagged ‘mental health’

No, you can’t say “faggot” around me.

Posted: October 2, 2014 in Uncategorized
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When I teach classes, I often talk about boundaries, those gold plated ideals that make relationships healthy (or not).  Boundaries are really difficult to pin down, even for someone who’s been leading lectures and groups about boundaries for a bit over five years.  In short, they are your limits, what is and is not okay with you.

Boundaries are important to address for anyone, but particularly in cases of abuse and trauma.  Most survivors of childhood trauma (including, but not limited to, abuse) have no concept of their limits mattering.  

When they say “no”, it is not respected; their bodily autonomy, their pain, their mental and physical being, are of no consequence.  Living through this often means adults who are at the extreme ends of the boundary spectrum.  Either one rarely says “no” because they believe it is meaningless, and do not feel comfortable speaking up for their needs (think of a person who is uncomfortable with a full body hug, but does not pull away or ask others to stop, or someone who tells you their life story after just meeting you), or can be completely closed off, avoiding all physical and emotional contact with others, for fear of being taken advantage of.  These are when we have boundary issues.

All people desiring healthy, rewarding relationships need the ability to set limits with those around us (and know what our limits are).  However, just because boundaries are with others does NOT mean they get respected, and this is where things get a bit sticky.

I can assert my boundaries, but that doesn’t mean you’ll respect them.  You have control over you, and I have control over me.

As an example, one of my close friends is constantly calling other people “pussy” and “faggot.”  I find both of these words extremely offensive; not only do I have close LGBTQ friends, I am acutely aware of how language perpetuates prejudice and oppression (with often fatal consequences) and shows my friend’s incredible privilege as a cis, straight white male.

I have repeatedly asked him to not use the words; I have tried to open up discussions about how language is super powerful; I work to make him realize how stupidly offensive it is to use these words.  However hard I try, I cannot control what he does.

If I assert my boundaries, and they are not respected, I have a choice.  I can continue to assert boundaries, and I can leave.  Sometimes, the best assertion is a clear consequence and an I statement.  Put on your learning cap!

I feel ___________ when you ___________.  I would like it ____________.  If you continue ______________, I may have to leave the room/conversation.

I feel uncomfortable when you use the word faggot around me.  I would like it if you could try not to use those words around me.  If you keep using these words,  I may not be able to continue to be around you.

At that point, you can leave and come back, ensuring you follow through on your consequence.  And it’s worth looking at – why would you keep spending time with someone who doesn’t respect your limits, or the basic humanity of human beings?

At the end of the day, you cannot love others using the language of murder, torture, oppression and hate.

on loving yourself as a form of weakness.

Posted: February 6, 2014 in Uncategorized
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So therapy for eating disorders, and really therapy in general, is all about being gentle and kind to yourself. Often, our mental health hinges on ingrained sense of worthlessness, habits of kicking ourselves when we’re down, and long held patterns of shame.

good?

To move toward recovery, one needs to start putting old behaviors behind, including negative self-talk, self-harming behavior (which, coincidentally, includes binge eating and exercising as a form of punishment ) and basing worth as a person on achievements and how hard one is working to change what is “bad.”
I’ve also been pretty heavily looking at the Intuitive Eating program, which focuses on the idea of trusting your body to know what it wants to eat and how much it needs to eat. One of the examples that’s stuck with me is that instead of saying things like “I really ate like a pig today” or “man, I need to do better tomorrow,” you’d focus on thoughts like “I had many opportunities to honor my hunger today” or “my body really needed rest today.”
Part of recovery is this reframing. But I realized this morning I keep thinking of this kind of thinking and attitude is a sign of weakness.
Now, pushing ourselves is a time tested value of our culture; for many with ED, pushing ourselves looks like a constant barrage of “never good enough.” These thoughts are fueled by fear – fear that if, for whatever reason, we calmed down our self-flagellation, we would be down the path of no return, eating until we burst and never exercising again. This kind of thinking is ridiculously hard to change. Imagine being miserable with yourself all the time, but scared to change because you could worsen exponentially.
So how do we move forward? How to rebuild trust in a body we hate? How to rekindle love for the body we’re in? How to truly believe we can truly stop punishing ourselves, that what we are really is enough? Unfortunately, like everything else, the best teacher is experience, and experience only comes after we take that leap of faith.

medication and shame

Posted: November 29, 2013 in Uncategorized
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not just feeling sorry for yourself

In mental health there is and has been a hot debate about the efficacy of medication to treat mental illness concerns.  Most research and evidence shows the quality of the relationship between therapist and client is the most robust factor predicting change and improvement (studies here).  Medication is rarely enough to cause real and positive change in someone struggling with mental illness; although a portion of the population, about 6% is diagnosed with severe and persistent mental illness (SPMI), the vast majority of those who are prescribed medication to treat mental illness are generally high functioning.  While one in four adults will suffer from mental illness in a given year (which is a huge number – 25%??  Whoa!), we still have an enormous complex about being open and honest in our quest for recovery.

Our cultural ideal is rugged independence – we score higher on that dimension than any other country on earth.  We look up to those who have made it on their own and pulled themselves up by their bootstraps.  This ideal doesn’t hold up well for most of us in the human race; we need social connections to survive , we benefit from collective action (unions, suffrage, state government road maintenance) and most of us need help learning what we do before we can support ourselves – even those who don’t do college were most likely apprentices, learning from someone who knew what they were doing.  Why wouldn’t mental health be the same?

Few mental illnesses require lifelong medication and maintenance; these are the SPMI, including Sczhizophrenia, Bipolar I Disorder and Major Depressive Disorder, recurrent.  These disorders disrupt normal functioning and cause significant distress for those suffering from these illnesses as well as those around them.  Major Depression isn’t just feeling sad and eating some ice cream after work; it’s not being able to move, not caring enough to shower, not having the energy to follow through on suicidal thoughts.

why do we make people ashamed for making an effort?

Beyond these, the most serious disorders, are significant mental illnesses of a potentially shorter duration.  One can be in a depressive episode (lasting about 2 weeks) and need medication to break out of that period, but may not require lifelong medication maintenance.  Obsessive disorders require extensive behavioral and cognitive therapy to replace harmful behavioral/thought patterns with more adaptive versions.  Certain medications can help with correcting these patterns and in rebuilding receptors to prevent a return to maladaptive behavior.

Mental illness is just that – an illness.  With the small exception of religious exemptions, we don’t chastise people for taking medication to cure their strep throat or to manage acid reflux.  It’s time to stop shaming ourselves and others for trying to recover.

other people telling me i’m beautiful

Posted: November 16, 2013 in Uncategorized
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So this morning I heard a song in my trampoline exercise class (which is fabulous, as you can imagine) with a chorus of “Only you can make me feel beautiful.”  Me being me, I started thinking about all the times that people tell others how beautiful they are.

imagine!

First and foremost, one of the hallmarks of individuation is being able to know who you are and what you think about yourself, not being moved from who you are by feedback from others.  Gestalt therapy notes one of the issues leading to neurosis is a lack of clear boundaries between “me” and “not me.”  In our internet articles, magazines, books, and movies, it is emphasized  how “sexy” confidence is and how we have to be our own people.  However, this overt message contrasts with the covert messages in the products of popular culture; in this case, music and movies are the most obvious examples.

A lot of responsibility is placed on our partners for our feelings.  We assure people that we can see beyond the outside and we like what we see.  We place our very survival on another person simply being around.  The number of these messages is tremendous and transcends genres and generations.

oy vey.

Aside from the obvious neediness and lack of our own lives here, there are a few intersections with mental health theory which may not be so stark.  Firstly, women (and men, to a lesser extent) are stuck waiting for their perfect partner.  I can’t be beautiful unless someone’s telling me I am.  I can’t feel beautiful if my partner doesn’t constantly assure me I am.  I can’t feel beautiful and be single.  I can’t feel beautiful when my partner isn’t making me feel I am.

The other aspect has to do with a defensive reaction, something we’ve talked extensively about and that motivational interviewing therapy ‎ is built to reduce.  When we’re told something, that we should do something or we are a certain way, a lot of us have a knee jerk reaction, a defense, that NO WAY reaction.  Even when it’s a “good” thing or “good” behavior we’re being pushed into.  The problem is the push.

so if i do, it’s your fault!

Does telling someone they’re beautiful defeat the purpose?  I know when someone tells me they’re having a bad hair day, and I tell them it looks fine, most of the time they dig in their heels to convince me I’m wrong and they’re right.  In psychology circles, it’s known as the confirmation bias and surprisingly (or not), it confirms we’d rather be right than happy.  We’d rather confirm I’m right about being ugly than be wrong and be beautiful.

The point isn’t to stop telling our partners they are beautiful or to stop accepting complements, but that we first need to change our self-concept and correct the stories we tell ourselves.  Only when we see ourselves as beautiful can we hear and appreciate others telling us the same.

my boundaries not your boundaries

Posted: November 6, 2013 in Uncategorized
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Recovery is a tricky thing.  Not just because there’s triggers everywhere you look, but because it’s a personal journey, and often a bit different for everyone.  How much should you say to a stranger?  How do you explain why you’re drinking club soda, or why you don’t keep candy in the house, or why you had to move out of your childhood neighborhood?

this is how we cut ourselves down so other women will feel comfortable around us.

This is a question I’ve been struggling with (so bear with me, this article may have fewer references than usual).  One of my big triggers is having people discuss weight loss efforts, so you can imagine my day to day life is triggers galore.  I read an article about body hatred as a bonding technique for women , but we can all testify to the truth of it without even reading the supporting literature. The literature that’s even in Glamour  – it’s so SHOCKING that women have poor body image, isn’t it?! It’s ubiquitous for women to share their hated body parts (“god, my ass is so big!”), weight gain (“I swear I gained 5 pounds just looking at that cake!”), weight loss efforts (“I shouldn’t eat that cookie”), sage family advice (“once on your lips, forever on your hips”) and so on.  This talk is everywhere in every kind of situation, and can serve as filler for silences or in new, uncomfortable situations.

While this discussion is old, my concern is where those in recovery should draw the line between speaking up and letting conversation pass.  I don’t suffer from anorexia, but I would assume listening to thin women (or women of any size) complain about their shape would be difficult to deal with.  It’s difficult for me to deal with!  The question is, do I ask other people not to talk about those things around me?  Or do I just refrain from engaging in that conversation?

It’s different with close friends, who, at least in my case, know that I’m dealing with food issues and for the most part respect my desire not to talk about weight loss.  It’s different with coworkers, or people in the gym, or clients.  With client’s its easier, because there it’s a clear distinction between therapist and consumer.  Do I tell my supervisor not to discuss her daily eating plan because it makes me want to binge?  Do I share with the woman who uses the locker next to mine that when she tries to get me to buy her diet products, it is uncomfortable because I’m aiming for recovery?

how much hate can you stand?

We tell alcoholics and addicts to avoid liquor stores and “wet places.”  To be assertive in their recovery.  At the end of the day, however, I believe most of recovery is dealing with your own stuff.  It’s not anyone’s responsibility not to talk about diets but mine; my responsibility is to increase awareness and manage my reaction to these triggers, because in no reality are triggers always avoidable.  Sometimes, though, that boundary is hard to maintain.

 

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